Pro-life medical providers and ministry organizations in Illinois are advancing their legal battle to the federal appeals court, challenging a state law that they claim compels them to violate their religious beliefs by requiring referrals for abortion.
The case, National Institute of Family and Life Advocates v. Treto, centers on an amendment to Illinois’s Health Care Right of Conscience Act.
The controversy stems from a law that stipulates that any healthcare professional who declines to perform abortions for reasons of conscience must nonetheless inform women about the “benefits” of abortion and refer them to abortion providers if they wish to retain certain conscience-based legal protections.
Pro-life groups, including pregnancy centers and doctors, are challenging the referral mandate, asserting it strikes at the heart of their religious freedom.
Earlier this year, a federal district court delivered a split ruling, striking down the provision requiring professionals to share the supposed “benefits of abortion” as unconstitutional compelled speech. However, the court allowed the provision requiring pregnancy centers to refer pregnant women for an abortion upon request to remain in place, prompting the current appeal to the U.S. Court of Appeals for the 7th Circuit. Oral arguments are expected in early 2026.
Attorneys for the plaintiffs argue that forcing pro-life health care providers to refer patients to abortion providers constitutes speech that violates their core convictions. Eric Rassbach, senior counsel at the religious liberty law firm Becket, stated that “Forcing people of faith to be mouthpieces for the state’s approved messaging on abortion is nothing short of Orwellian.”
The Catholic bishops of Illinois, alongside the Illinois Catholic Health Association and Orthodox churches, have backed the lawsuit, arguing they seek to “ensure that no Catholic healthcare provider in Illinois will be forced to speak against the Church’s true teachings on abortion.”
Cardinal Blase J. Cupich of Chicago said that Catholics believe that “every life deserves protection and care,” and argued that the Church in Illinois is standing against the state’s effort to deny this eternal truth.
Bishop Thomas J. Paprocki of Springfield said the matter was a straightforward case of religious liberty.
”Catholics must be free to live according to the 2,000-year-old teachings of our faith without government intrusion,” Bishop Paprocki said. “Illinois’ mandate threatens that freedom by forcing Catholic ministries and healthcare professionals to promote a practice we believe is gravely wrong. We pray the court will put a swift stop to it.”
The legal battle in Illinois is one of several recent high-profile cases across the nation where state actions or legislative mandates have clashed with the religious or moral objections of health providers and religious organizations following the 2022 overturning of Roe v. Wade.
In June 2025, the U.S. Supreme Court took action in Diocese of Albany v. Harris, a challenge to New York’s mandate forcing religious groups—including Catholic and Anglican nuns and faith-based social ministries—to pay for employees’ abortions.
The Supreme Court ordered New York courts to reconsider the mandate, citing Becket’s unanimous victory in Catholic Charities Bureau v. Wisconsin Labor & Industry Review Commission. Opponents of the New York rule argue the state unfairly narrowed the religious exemption to exclude ministries that serve all people regardless of faith, such as the Carmelite Sisters for the Aged and Infirm and their nursing home.
The Supreme Court also agreed to hear an appeal from First Choice Women’s Resource Centers, a faith-based pregnancy center in New Jersey. The organization is challenging a subpoena issued by the New Jersey Attorney General seeking information about its operations and potential misrepresentations regarding abortion referrals.
The center, represented by Alliance Defending Freedom (ADF), contends that the investigation targets them solely for their pro-life views and chills their First Amendment rights.
Meanwhile, in Indiana, a state appellate court upheld a preliminary injunction against the state’s abortion law. The successful challenge, brought by members of diverse religious faiths, argued that the ban violated the Indiana Religious Freedom Restoration Act (RFRA) because the law accommodated secular exemptions (like rape or incest) but denied exemptions for religiously motivated decisions, thus triggering strict scrutiny review. The court concluded the state failed to demonstrate a compelling interest for denying religious exceptions when secular ones existed.
Conflicts are also arising in medical settings, as seen in California, where Providence St. Joseph Hospital was sued by the state Attorney General over allegations it denied emergency abortion care to a woman experiencing a miscarriage. The Catholic-owned hospital subsequently agreed to a temporary stipulation requiring it to comply with the state’s Emergency Services Law and allow physicians to terminate a pregnancy if not doing so would seriously risk the patient’s health.